1. Children’s Therapy Initiative – Central Region (CTI-C) “Coordinating therapy services that assist children to reach their full potential.” “A New Way of Working Together”

2. Current CTI-C Participating Partners Include, but are not limited to: Family Services & Housing RHA-Central MB. Inc. Child & Family Services Healthy Child Coalition Rehab Centre for Children Society for Manitobans with Disabilities School Divisions: Border Land, Franco- Manitobaine, Garden Valley, Pine Creek, Portage La Prairie, Prairie Rose, Prairie Spirit, Red River Valley, Western

3. 3 Children’s Therapy Initiative – Central Region Timeline Phase 1 Phase 2 Phase 3 Oct 2002 --- May 03 June 03 – Mar 05 April 05 - present > Formation of an interagency team > Conducted a regional children’s > Begin implementation & ongoing to respond to call for proposal. therapy services scan & report of development of Demonstration Plan current services and gaps. with coordination of services by Aug. 03- Mar. 04 provider agencies.  Development and Submission > Development and submission of a > Recruitment of additional therapy of initial proposal Regional Demonstration Plan staffing and resources through new April 04 provincial funding.  Provincial acceptance of Central’s > Approval of Plan by Province > Ongoing Interagency data/financial proposal as one of 4 initial provincial Dec. 04 reporting to Provincial committee with proposals to develop a demonstration identification of needs for additional project plan. > Announcement of some additional funding. Provincial funding to begin > Implementation of Central Intake- for implementation of the preschool services and OT, PT school Demonstration Plan – Feb. 05 based services provided by RCC or RHA. – Jan. 06

4. Current CTI-C Outcomes for Coordination of Therapy Services in our region Eligibility criteria Referral Access Central intake & Data Base Provider Agency coordination/partnerships Service delivery model Sharing of information Access to information

5. Common Criteria Any child (birth to school exit), living within the boundaries of RHA-Central, with an “identified developmental concern” in areas such as: - Speech (language, communication) –Hearing –Motor (fine, large, or oral motor) –Cognitive (learning, self-help skills) –Sensory processing –Social development

6. Common Referral Sources Family Physicians Pediatricians Child Development Clinic School Resource/Student Services Coordinators. Child & Adolescent Mental Health Other Therapy Providers Preschool/school screening Public Health /Families First Family Services & Housing - CSS Child Care Directors Child & Family Service Agencies The referral source must obtain parent / legal guardian consent (Referral form and information pamphlet developed by CTI-C.)

7. Central Intake – Live as of Jan. 06 Central Intake: –RHA- Regional Rehab Services Boundary Trails Health Centre Box 2000 Station Main Winkler, Manitoba R6W 1H8 Phone: 1-800- 958-3076 Fax: 1-204-331-8913 - School based SLP referrals will continue to be directed to the appropriate school division.

8. Central Intake Process and Data Base The Central Intake process will ensure: Parent / guardian consent for referral has been obtained. Review of referral by a rehab professional: – OT/PT/SLP/Audiologist The referral is forwarded to the appropriate Provider Agency. Referral information is entered in a Common Data Base. Acknowledgement of receipt of referral back to the referral source.

9. Central Intake will forward the referral to the appropriate Provider Agency/Agencies. The Provider Agency/Agencies will then contact Parents/caregivers informing them of: Receipt of referral Approximate wait time for service Contact for date of initial appointment Agency contact number If more than one Provider Agency or therapy service is involved, the Agencies/therapists will coordinate service planning with the family.

10. Common Flexible Service Delivery Model Parents, therapist and other team members will work together to assess, identify goals and establish a plan to meet the child’s needs within available resources. Services may be provided in a variety of settings depending upon the needs of the child / family. Flexible service delivery model including direct intervention, collaborative consultation and education to ensure continuum of care. Service providers will facilitate communication, with regular review of the child’s progress for seamless transitions and provision of service.

11. Coordination of Service using common service criteria and flexible service delivery model. RCC & RHA – geographical realignment of preschool OT and PT services within region SMD & RHA – geographical realignment of preschool SLP services. School based SLP remains the same School based OT, PT – current status -contract/ fee for service, continuing to work with school divisions on coordination of these services.

12. Service augmentation with new CTI-C funding 1.0 EFT SLP – RHA 0.4 EFT OT- RHA 0.1 EFT PT – RCC Increased service for preschool waiting lists, children who are home schooled or attending non-funded private schools and community preschool screening days. Allocation of funding for travel and resources to mobilize existing and new therapists for community based, flexible service delivery. Provincial CTI funding to Francophone SD for 0.1 EFT SLP -Preschool French Language Services Term 0.4 EFT CTI-C Transition Coordinator Set up and operating costs of a 1-800 number at Central Intake.

13. Sharing of Information In compliance with Provincial legislation with respect to PHIA & FIPPA: Parent/guardian consent required for referral to CTI-C. Parental/legal guardian CTI-C release of information form developed for use by the Provider Agencies for the consent for sharing of information. A data sharing agreement to be developed and signed by all participating Therapy Provider Agencies.

14. Access to information about therapy services? Information about CTI-C therapy access and service will be available through: Verbal inquiries - Central Intake 1-800 number established. Inquiries will be directed appropriately. Informational pamphlets developed by the CTI-C (French and English) will be available at all referral sources, and community resources for public information.

15. What’s Going Well Committed intersectoral CTI-C team Continual increased understanding of each others programs and services Increased links between service sectors New referral process more user friendly

16. Challenges Lack of a secure data system to facilitate development of a Central Intake and data base. ?Provincial data base module for all CTI’s Development of an intersectoral Data Sharing Agreement - ? Provincial template for all CTI’s Needing more direction from Provincial CTI Boundary difference between sectors- some SD’s required to coordinate service with more than one region

17. Challenges Union/contract barriers to sharing of therapy positions between partners. Costs and time associated with development, implementation and administration of CTI by participating partners not covered by funding. Recruitment and retention- limited financial resources for rehab professional resources and professional development

18. Unintended Outcomes Realization that use of different terminology by partners – requires clarification to maintain communication. Greater awareness that CTI-C impacts each participating partner differently. System and sector reporting differences can impact team communication. Trust between partners impacted by consistency of communication/feedback loop.

19. Next steps for the Children’s Therapy Initiative- Central Achieving Provincial Outcomes Regional Partnerships Further service coordination to build capacity and maximize existing and new resources. Explore opportunities to partner with First Nation Communities. Access to Information and services Determine community learning needs and explore shared learning opportunities. Common Intake Further development of system technology to support data base. Consistent data collection for future planning needs. Continuum of service Further identification of adequate therapy resources. Regional consistency of therapy Practice Standards New Born Hearing Screening Transition Planning Develop consistent transition process throughout child’s age continuum. Evaluation Develop indicators and outcome measures. Parent / stakeholder feedback